to wonder why a midwife would offer a woman, labouring beautifully in a pool, an epidural?

[FeckinFurious]

I have namechanged as I'm not sure if this is a bit obvious and I need to ensure confidentiality.

But...

I am utterly fuming.

Scenario.

Woman. Baby no 1. Labouring spontaneously in hospital, in a birth pool.

Long and painful but baby fine. Mum tired but coping, using entonox.

Midwife 1 goes off for lunch. Midwife 2 takes over.

By the time midwife 1 comes back from lunch midwife 2 has suggested an epidural to knackered, labouring woman who accepts.

within haf an hour epidural is sited and hormone drip going.

Woman is now being monitored continuously in bed.

Please comment.

Bit of a treehugger website but there's a nice description of the benefits of waterbirth here.

Water has strong pain relieving and relaxing properties and is very successful in reducing the need for other pain relief.

It also carries none of the risks that go with epidurals or narcotic pain relief.

Some people feel it is a much more pleasant transition for the baby to be born into warm water (certainly, I'd have sworn my baby came out of the water with a smile on his face!)

Epidurals carry significant risks for mother and baby. They can cause rapid drops in blood pressure and cause lasting damage to the spine. It's best to try other options first, if possible. A change in position, for example can make all the difference.

That tired old phrase 'There are no medals for going without pain relief' means nothing.

No one expects a medal. The reason some women choose to go without epidural and narcotics is, as others say, because it presents less risk to the baby (and the mother). Simple.

I also entirely agree with the poster who wonders if this is a case where the mother is retrospectively blaming the father for possibly 'not supporting her enough'. One thing is clear, an anaesthetist does not set up an epidural and inject you without your consent - it's not even like jabbing a needle in your leg is it - it takes a while to set up. The woman clearly gave consent at the time, and afterwards wishes she'd managed to go without. She needs to re-examine her own response to labour, not shift the responsibility for her decision onto a third party.

People have said it before... but in response to the person saying "why do people think natural trumps drugs and epidural...?"... well it's better for the mum, post natally, and for the baby. That's not a "wow, look at me, I did it with no drugs at all, give me a medal" kind of attitude, it's a "I've weighed up the options, and realise that if I have the drugs, I am more likely to end up with this intervention, and that problem for the baby etc".

That's all.

It isn't always better for the mother, boobz, just more often, statistically speaking. I have met mothers who have been totally traumatised by painful labours.

My own grandmother was so traumatised by her experience (homebirth, village setting, long before efficient pain relief) that she was never able to contemplate having another baby. I and my mother, who both gave birth in settings where we knew we could have pain relief if we asked for it, are otoh completely relaxed about our birth experiences and both went on to repeat the experience.

I did not feel a failure after my emergency caesarian (second pregnancy)- in fact, I felt pretty euphoric- so I find it hard to believe that I would have felt a failure if I had asked for an epidural in my first.

People are all different. That's why it's so important to listen to them as individuals.

MillyR - it does feel different. Have you ever had a warm bath for really bad period pain? A bit like that. Still there, but less unpleasant...

In my own case, what I found reassuring was the knowledge that I can ask for pain relief if it gets unbearable, I am allowed to change my mind, people will listen. In the event, it never did get that bad, but I think it was that reassurance that helped me keep going.

Don't recollect any particular euphoria or feeling of strength related to having pushed the baby out; my feelings were all focussed around the baby- in much the same way as after my subsequent caesarian. It wasn't traumatic, but just not that big a deal to me.

I begged for an epidural during my dd's (home)birth. The mw's and my doula exchanged knowing glances. Dd was born 15 minutes later.

It's normal ime and IMO for a labouring woman to say she can't do it. A good mw will know the difference between a woman in transition who just needs a little g&a to relax her or encouragement for the final stage, and a woman who is genuinely in need of an epidural.

I agree cory! (with previous post) After I'd had DC1 my mother-in-law came and heard all about my mobile epidural. From her reaction I think she is still traumatised by her births, three of which were at home.

I totally buck the statistics because the only time I've ever come near to forceps/intervention was in 2nd labour where did not have epidural and was panicking too much to listen to the midwife. So third time round went straight for epidural. Was fab. For me no pain has meant calm, able to push, able to pant, happy. Like you say, we're all different...

Yes Cory, I rushed my post - I meant to say "statistically speaking" and "more often"... I do realise that for some people, feeling the pain or having to endure that level of pain and exhaustion has a worse effect on them than the subsequent interventions they're more likely to have as a result of asking for pain relief and receiving it...

I guess the main point I was trying to make though, wasn't that it's always better for mum and baby, only that people who say they want to try for a drug free birth are doing so to try and improve the chances of a more positive post-natal experience, for both them and baby, and NOT because they will feel they have "trumped" anyone else who has had an epidural, or other kind of drug.

What cory said. Despite having an epidural, I went on to push the baby out 20 minutes after I started pushing, with no forceps/ventouse, or any ill effects to the baby or myself. And the epidural immeasurably increased the quality of the experience.

I couldn't have coped with the ghastly midwife AND the pain, and I did not feel that I could have just sworn at her or relieved my feelings with a display of anger.

'There are no medals for going without pain relief' - it might be a "tired old phrase" as people have contemptuously referred to it, but it accurately reflects what I think.

And the humour used regarding the phrase "labouring beautifully" was, I think, a very sensible and measured response to an OP who displayed actual anger at the thought that a woman might accept pain relief.

If the OP was the woman in labour I suspect that she would have had and given more info as to the asking/accepting circumstances, would not have used the phrase "labouring beautifully" which is, as we now know, an Important Midwife Phrase rather than ordinary English, and she used the phrase "I need to ensure confidentiality" rather than "I don't want to identify myself".

I think the thing that pisses me off about 'labouring beautifully' is that it is so judgmental - another stick with which to beat a woman if she finds it hard or it is just taking ages or she wants pain relief etc. Saying "her labour is going well" or "her labour isn't going well" is not a judgment on how the woman is doing. Saying "she is labouring beautifully/well" and therefore the implied opposite (which may never be spoken) that "she is labouring badly" is a subtle shift in language (labour as verb rather than noun) but becomes a judgment on how the woman is doing. If this is common phraseology amongst midwives, why don't they just cut to the chase and start giving us marks out of 10 for style, effort, speed and artistic ability like we're all bloody contestants on Dancing on Ice...

perhaps opinions on this very much depend on your own experiences. If you were denied pain relief for some reason, you're probably going to think that being offered and having the chance to say yes or no is a great thing.

But if, like me, you live in an area where you hear loads of stories from women who DID feel they were coping ok, but were repeatedly offered pain relief anyway then you start to wonder just who's benefit the pain relief is actually for. Because those women didn't need it. They weren't asking for it. They weren't 'not coping' or 'labouring badly'. So why was a medical professional supposed to support them pushing for them to have pain relief. Could it be because its a busy teaching hospital? Could it contribute to the hospitals high section rate?

So while I agree, the decision about whether to use pain relief should be entirely up to the labouring woman I do think that the way it is perceived and offered by the attending staff is important too.

So we still don't know if FF is:

MW1
MW2
Mother
Father
Baby
Easter Bunny
None of the above

?

"Don't recollect any particular euphoria or feeling of strength related to having pushed the baby out"

Cory - it's mainly a hormonal thing. Women who give birth without synthetic oxytocics and pain relieving drugs generally have much higher levels of endorphins and oxytocin in their bodies immediately post birth.

I had a highly medicated birth with my first baby - was of course delighted beyond reason to finally be holding her in my arms. However I can say I definitely experienced a different kind of euphoria after my unmedicated births. I don't love dd any the less than my ds's and bonded with her brilliantly. I am grateful to have experienced that hormonal high after my second and third labours though - I think of those hormones as 'mothers little helpers', and feel they helped speed up and intensify the bonding process.

"Saying "she is labouring beautifully/well"is that it is so judgmental - another stick with which to beat a woman if she finds it hard"

Oh nonsense! It's simply a comment about how the labour is progressing in physiological terms! It's not any sort of value judgement on the mother's response to the labour or her feelings about it!

What is it with women on this site - looking for ways of victimising and stigmatising themselves!

"to an OP who displayed actual anger at the thought that a woman might accept pain relief."

Actualy the OP was angry that an epidural had been OFFERED to a mother who she believed to be making normal progress and coping well with her labour. She said nothing judgmental about the mother herself!

"A good mw will know the difference between a woman in transition who just needs a little g&a to relax her or encouragement for the final stage, and a woman who is genuinely in need of an epidural."

Sometimes!

But you also have to admit that the body is a bit of a mystery and sometimes even the best midwives get it wrong - on both hands (fobbing mothers off who really might benefit from an epi, or suggesting it to mothers who would probably be better off without one).

I'd suggest that the way maternity care is delivered in this country in some places at the moment makes these misjudgements more common than they should be.......

I felt positively euphoric during dd's labour. I remember sitting on the loo and giggling to dh "I feel like I'm coming up on a pill!" The only euphoria I felt with ds' birth was when the anaesthetist turned up. Then I told him I loved him.

I loathed the feel of water when I was in labour, it felt like slime. Can't even watch waterbirths now without feeling itchy. Same when watching birth videos with husbands stroking and stuff, anyone pawing at me would have lost their arms.

Different women labour differently, we all have different bodies, we have different minds, different pain thresholds, different ideas.

I felt like a GOD when I pushed him out, absolute rush of "Fuck, aren't I a legend?".

I remember ds's homebirth (which involved a shoulder dystocia, two ambulances and paramedics running up the stairs with resucitation equipment) as the happiest and most exciting day of my life. I had the biggest, biggest high after the birth.

I took acid in the 1980's a few times - on one occasion had an ecstatic experience of being 'at one with the universe'. Ahem. Felt similar after ds's birth. Only better because I wasn't queasy and didn't keep seeing faces coming out of the wall.

"I felt like a GOD when I pushed him out, absolute rush of "Fuck, aren't I a legend?".

Watching a woman giving birth can inspire that sort of awe - I think mums are bloody amazing. All of us. [admiring glances at assembled company]

I am always amazed on here when women talk about their DH's being freaked out. DH was just like "Bloody Hell, that was impressive - we can just make our own people now".

It is worth saying though that I get a pretty easy ride with pregnancy/birth so there isn't really any trauma to be gotten over. Completely down to luck (though I suspect the hypnobirthing helps).

I had my first baby with no pain relief & definitely felt a huge rush to know I'd done it all on my own without so much as gas & air.

Second time round I had paracetamol, a drip to help open my cervix, a pethidine equivalent, an epidural & oxytocin. Still felt the same rush when he was finally born as I had to work just as hard if not harder than first time round.

Both times I narrowly avoided intervention due to the heart rate dropping. I only avoided it second time round due to a fantastic mw who kept getting me to change positions until we found one baby liked better. It turned out the cord was short & had been being compressed & the change in position relieved the pressure. My first labour I was told I had 2 more contractions to get him out before they used a ventouse. Had been pushing a long time second time round & narrowly avoided an episiotomy.

I have felt amazing rush with all three but was most euphoric after most recent and most medicalised - induction, drip, epidural. It was just such a lovely mellow birth and was in shower half an hour later. (Went private and had lovely one-to-one care throughout, I'm sure that contributed.)

As opposed to the non-epidural panicky one where I just felt relief and shellshock afterwards. I still think that back to that one negatively - even though by midwife standards I probably laboured 'beautifully' (fast, no epidural, pushed out 9 lb 14 oz on own. Too fast for me, actually. Freaked me out.)

So maybe all our endorphins don't work the same way... ? I am happy when I am in control, maybe that's it.